The RACE scale is a simple tool that can accurately assess stroke severity and identify patients with acute stroke with large artery occlusion at prehospital setting by medical emergency technicians.

Patients finally diagnosed with AHF at then ED that have received LIPHT by the ALS ambulance teams have a poorer short-term outcome, especially during the first 7 days.

La parada cardiorrespiratoria (PCR) es una situación de máxima urgencia médica que potencialmente puede revertirse si se inician maniobras de reanimación cardiopulmonar (RCP) básica de forma inmediata. Sin embargo, esto sucede en menos del 25% de las PCR presenciadas por los testigos, por lo que es necesario incrementar el conocimiento de estas maniobras en la población general. Una forma de que este conocimiento pueda alcanzar a toda la población es introducir su enseñanza durante la educación obligatoria, como muchas organizaciones especializadas en esta materia recomiendan. Este trabajo analiza las iniciativas llevadas a cabo en este sentido en España, incluyendo la experiencia de los autores en el desarrollo del PROCES, un programa dirigido a los estudiantes de 15 y 16 años que se lleva a cabo desde hace 10 años en la ciudad de Barcelona.Palabras clave. Parada cardiorrespiratoria. Educación obligatoria. AbstrActCardiorespiratory arrest (CRA) is a situation of maximum medical emergency which can be potentially reversed if basic cardiopulmonary resuscitation manoeuvres (CPR) are provided by the first bystander. Nonetheless, this is done in less than 25 % of the cardiorespiratory arrests (CRA) witnessed by bystanders. Thus, it is urgent to increase the knowledge of such basic CPR manoeuvres among the public in general. One strategy consists in the teaching of basic CPR techniques in schools following the recommendations made by specialized institutions. This study analyzes the initiatives carried out in Spain, including the authors' own experience acquired during the development of PROCES, a program aimed a students from 15 to 16 years of age and carried out during the last 10 years in Barcelona. Ayudas recibidas para este estudio: Los autores han recibido soporte técnico y/o ayudas parciales para llevar a cabo el PROCES durante los 10 últimos años de la Universitat de Barcelona, Ajuntament de Barcelona, Nestle y Laboratorios Menarini, pero dichas ayudas no han tenido ninguna relación con el contenido científico de este trabajo.

Aim To illustrate the pre‐hospital management arsenals and protocols in different EMS units, and to estimate the perceived difficulty of diagnosing suspected acute heart failure (AHF) compared with other common pre‐hospital conditions. Methods and results A multinational survey included 104 emergency medical service (EMS) regions from 18 countries. Diagnostic and therapeutic arsenals related to AHF management were reported for each type of EMS unit. The prevalence and contents of management protocols for common medical conditions treated pre‐hospitally was collected. The perceived difficulty of diagnosing AHF and other medical conditions by emergency medical dispatchers and EMS personnel was interrogated. Ultrasound devices and point‐of‐care testing were available in advanced life support and helicopter EMS units in fewer than 25% of EMS regions. AHF protocols were present in 80.8% of regions. Protocols for ST‐elevation myocardial infarction, chest pain, and dyspnoea were present in 95.2, 80.8, and 76.0% of EMS regions, respectively. Protocolized diagnostic actions for AHF management included 12‐lead electrocardiogram (92.1% of regions), ultrasound examination (16.0%), and point‐of‐care testings for troponin and BNP (6.0 and 3.5%). Therapeutic actions included supplementary oxygen (93.2%), non‐invasive ventilation (80.7%), intravenous furosemide, opiates, nitroglycerine (69.0, 68.6, and 57.0%), and intubation 71.5%. Diagnosing suspected AHF was considered easy to moderate by EMS personnel and moderate to difficult by emergency medical dispatchers (without significant differences between de novo and decompensated heart failure). In both settings, diagnosis of suspected AHF was considered easier than pulmonary embolism and more difficult than ST‐elevation myocardial infarction, asthma, and stroke. Conclusions The prevalence of AHF protocols is rather high but the contents seem to vary. Difficulty of diagnosing suspected AHF seems to be moderate compared with other pre‐hospital conditions.

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